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Entry Form XI

FORM 11

[See rule 11(5)]

Year of Assessment:

Registration Certificate No.

To,

......................................

......................................

......................................

 

NOTICE

Take notice that you have finally assessed under the Goa Tax on Entry of Goods Act, 2000, a tax of Rs. ............ (Rupees ............................. ................................... (in words), only) for the year ending ............ The total amount of tax paid by you already Is Rs. ............... (Rupees .................................................. (in words), only) that is ............ in excess of the tax due.

2. The sum of Rs. ............ paid by you in excess as state above is refunded/ adjusted towards ...................... due by you for the year ................

The refund payment order and refund adjustment order is/are enclosed.

Value of goods determined by the assessing authority is given (below).

 

Total Tax payable

Total Tax paid

Excess amount due

Date of assessment

 

 

Place:

Date :

 

Signature of the Assessing Authority

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